diverse towns in four Australian states (total population 72 000 16e29-year-olds). To date, 27 towns have been randomised (13 intervention, 14 control). Intervention and control towns are similar: baseline chlamydia prevalence (5.8%, 95% CI 4.4 to 7.5% vs 5%, 95% CI 3.9 to 6.3%, individual response rate 63%); past chlamydia testing rate in 16e29-year-olds (6.1%, 95% CI 5.8 to 6.4% vs 5.8%, 5.6 to 6%). After 3 months of the intervention in the first two towns the chlamydia testing rate was 10.9% (95% CI 10.1% to 11.7%; 691 people tested), a 160% increase compared with the testing rate (4.1%) in the year before the intervention.Conclusions Our high recruitment rate shows that Australian GPs are willing to test for chlamydia. The baseline data show a high prevalence of chlamydia among young adults in the study towns. While testing rates are increasing, ongoing work is needed to get coverage up to levels that might reduce prevalence in intervention towns. Results Of the first 100 patients offered a test 83% of patients approached were assessed to have mental capacity to provide informed consent for testing. 69% of patients offered BBV testing, accepted. The prevalence of HIV was found to be 3%. One individual was newly diagnosed with HIV and transferred to specialist care. Overall, 18% of patients tested were found to have a newly diagnosed or previous infection with a BBV. Conclusion It is acceptable to patients to be offered routine BBV screening in a psychiatric setting and the majority have capacity to consent; uptake rate is comparable to that seen in GUM clinics. HIV prevalence rate was found to be over four times higher than that of the local population. Given the elevated prevalence rates in psychiatric patients, there is a strong case for the wider introduction of routine testing in mental health settings. There is a need to systematically ascertain rates of infection in mental health patients across a range of geographical areas since the prevalence of BBVs appears to be higher than that in the local population. Background In 2008, a schools-based HPV vaccination programme was introduced for girls aged 12e13, with an accelerated catch up programme for those aged 14e18. A significant impact on cervical cancer rates requires 80% uptake of three vaccinations, however in England the completion rate was 58% in 2009/10. O9Aim To compare HPV vaccination outcomes and prevalence of risk factors, associated with HPV acquisition and cervical cancer development, in young women attending GUM clinics with national data. Method An anonymous questionnaire was given to 13e19 y/old women attending 19 participating GUM clinics from March to August 2011. Data were analysed using multivariate linear regression in SPSS. Results 2247 questionnaires were completed (median respondent age 17). Compared to national data, respondents were more likely to be smokers (48% vs 12% of 15 y/olds), have had coitarche aged <16 (52% vs 26%), have had an STI previously (29% vs 13% for <16 coitarche) or not be in education, employment or trainin...

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The introduction of UK clinical guidelines in 2006 set clear standards for the provision of postexposure prophylaxis for HIV following sexual exposure (PEPSE) to patients who present to health-care settings. However, some patients have reported wide inequities in provision of PEPSE. We used a questionnaire to evaluate staff awareness and provision of PEPSE in various clinical situations in three major emergency departments (EDs) in the Wessex region of the UK. Thirty-three doctors and 50 nurses completed the questionnaire. There was a general lack of awareness regarding local protocols, availability of postexposure prophylaxis (PEP) packs and whom to contact for advice. Knowledge about PEP provision varied according to clinical scenario but was better among senior medical staff. The deficits in awareness and knowledge of PEPSE among ED staff highlighted in this study raises concerns about patients' access to this intervention. We plan to implement local training to address these issues and raise awareness of the local genitourinary medicine/HIV services as a source of advice.

Elite control of HIV infection has been defined as spontaneous and sustained maintenance of HIV RNA to <50 copies/mL in the absence of therapy. It is estimated to occur in approximately one in 300 HIV-infected individuals. We present the case of a Zimbabwean woman who tested positive for HIV-1 infection on routine antenatal bloods at 15 weeks gestation. Her CD4 count was 500 cells/mm(3); however, HIV-1 RNA viral load measured below the level of detection on several assays. A Cavidi ExaVir reverse transcriptase assay was below the level of detection. Pro-viral DNA was positive using long terminal repeat primers and sequencing demonstrated subtype C virus. Zidovudine monotherapy (250 mg twice daily) was commenced at 24 weeks for the prevention of mother to child transmission. She was keen for a standard vaginal delivery, having had one previously, and she delivered a healthy baby without complications at 39 weeks gestation. The neonate received four weeks of Zidovudine and tested negative for HIV infection. We discuss some challenges involved in the management of a pregnant 'elite controller'.